<!DOCTYPE html>
<html>
<head>
    <title></title>
</head>
<body>



<form action="/gt/plus/diy.php" enctype="multipart/form-data" method="post">
    <input type="hidden" name="action" value="post">
    <input type="hidden" name="diyid" value="1">
    <input type="hidden" name="do" value="2">
    <table style="width:97%;" cellpadding="0" cellspacing="1">
        <tbody><tr>
            <td align="right" valign="top">选择产品：</td>
            <td><input type="radio" name="pro" class="np" value="亮颜青春宝活性精华面膜" checked="">亮颜青春宝活性精华面膜
                <input type="radio" name="pro" class="np" value="驻颜微塑形活性精华面膜">驻颜微塑形活性精华面膜
                <input type="radio" name="pro" class="np" value="童颜回春活性精华面膜">童颜回春活性精华面膜
            </td>
        </tr>
        <tr>
            <td align="right" valign="top">数量：</td>
            <td><input type="text" name="amount" id="amount" style="width:100px" class="intxt" value="0"> (填写数值)
            </td>
        </tr>
        <tr>
            <td align="right" valign="top">姓名：</td>
            <td><input type="text" name="uname" id="uname" style="width:250px" class="intxt" value="">
            </td>
        </tr>
        <tr>
            <td align="right" valign="top">性别：</td>
            <td><input type="radio" name="sex" class="np" value="男" checked="">男
                <input type="radio" name="sex" class="np" value="女">女
            </td>
        </tr>
        <tr>
            <td align="right" valign="top">地址：</td>
            <td><input type="text" name="address" id="address" style="width:250px" class="intxt" value="">
            </td>
        </tr>
        <tr>
            <td align="right" valign="top">手机：</td>
            <td><input type="text" name="tel" id="tel" style="width:250px" class="intxt" value="">
            </td>
        </tr>
        <tr>
            <td align="right" valign="top">留言：</td>
            <td><textarea name="msg" id="msg" style="width:90%;height:80"></textarea>
            </td>
        </tr>
        <input type="hidden" name="dede_fields" value="pro,radio;amount,int;uname,text;sex,radio;address,text;tel,text;msg,multitext">
        <input type="hidden" name="dede_fieldshash" value="27f451cdb23ca7d2ea438e946aff08e9"></tbody></table>
    <div align="center" style="height:30px;padding-top:10px;">
        <input type="submit" name="submit" value="提 交" class="coolbg">
        &nbsp;
        <input type="reset" name="reset" value="重 置" class="coolbg">
    </div>
</form>
</body>
</html>